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US sues Idaho as abortion law conflicts with medical treatment requirement

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The Justice Department filed a lawsuit to protect the rights of patients to access emergency medical care guaranteed by federal law.

The Justice Department on Tuesday, August 2, 2022, filed a lawsuit that challenges Idaho’s restrictive abortion law, arguing that it conflicts with a federal law requiring doctors to provide medically necessary treatment that for pregnant women could include abortion.

The complaint challenges Idaho Code § 18-622 (§ 18-622), which is set to go into effect on Aug. 25 and imposes a near-total ban on abortion and could subject doctors to a five-year prison sentence.

The complaint seeks a declaratory judgment that § 18-622 conflicts with, and is preempted by, the Emergency Medical Treatment and Labor Act (EMTALA) in situations where an abortion is treatment necessary to stabilize an emergency medical condition.

The United States also seeks an order permanently enjoining the Idaho law to the extent it conflicts with EMTALA.

The announcement is the first major action by the Justice Department challenging a state trigger law since the Supreme Court overturned Roe v. Wade in June. 

The court’s decision has led some states to enact restrictive abortion laws and is likely to lead to abortion bans in roughly half the states in the U.S.

“Idaho’s law would make it a criminal offense for doctors to provide the emergency medical treatment that federal law requires,” said Attorney General Merrick B. Garland.

“On the day Roe and Casey were overturned, we promised that the Justice Department would work tirelessly to protect and advance reproductive freedom,” said Garland. 

“That is what we are doing, and that is what we will continue to do,” Garland said. “We will use every tool at our disposal to ensure that pregnant women get the emergency medical treatment to which they are entitled under federal law. And we will closely scrutinize state abortion laws to ensure that they comply with federal law.” 

“Federal law is clear: patients have the right to stabilizing hospital emergency room care no matter where they live,” said Department of Health and Human Services Secretary Xavier Becerra. “Women should not have to be near death to get care. The Department of Health and Human Services will continue its work with the Department of Justice to enforce federal law protecting access to health care, including abortions.”

“One critical focus of the Reproductive Rights Task Force has been assessing the fast-changing landscape of state laws and evaluating potential legal responses to infringements on federal protections,” said Associate Attorney General Vanita Gupta. “Today’s lawsuit against the State of Idaho for its near-absolute abortion ban is the first public example of this work in action. We know that these are frightening and uncertain times for pregnant women and their providers, and the Justice Department, through the Task Force’s work, is committed to doing everything we can to ensure continued lawful access to reproductive services.”

EMTALA requires hospitals that receive federal Medicare funds to provide necessary stabilizing treatment to patients who arrive at their emergency departments while experiencing a medical emergency.

When a physician reasonably determines that the necessary stabilizing treatment is an abortion, state law cannot prohibit the provision of that care.

The statute defines necessary stabilizing treatment to include all care needed to ensure that a patient will not have her health placed in serious jeopardy, have her bodily functions seriously impaired, or suffer serious dysfunction of any bodily organ or part.

As explained in the complaint, once the Idaho law goes into effect, a prosecutor can indict, arrest and prosecute a physician merely by showing that an abortion has been performed, without regard to the circumstances.

A physician who provides an abortion in Idaho can ultimately avoid criminal liability only by establishing as an affirmative defense that “the abortion was necessary to prevent the death of the pregnant woman” or that, before performing the abortion, the pregnant patient (or, in some circumstances, their parent or guardian) reported an “act of rape or incest” against the patient to a specified agency and provided a copy of the report to the physician.

The law provides no defense for an abortion necessary to protect the health of the pregnant patient. 

Idaho’s criminal prohibition of all abortions, subject only to the statute’s two limited affirmative defenses, directly conflicts with EMTALA and stands as an obstacle to the accomplishment of EMTALA’s federal objectives of providing stabilizing care and treatment to anyone who needs it.

The Justice Department is committed to protecting access to reproductive services. Following the Supreme Court’s decision in Dobbs, the Justice Department established the Reproductive Rights Task Force, chaired by Gupta.

The Task Force is charged with protecting access to reproductive freedom under federal law. For additional information on the work of the Task Force visit www.justice.gov/reproductive-rights.

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